Provider Demographics
NPI:1487677431
Name:BEMBINSTER, GAIL M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:M
Last Name:BEMBINSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WINDSONG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5454
Mailing Address - Country:US
Mailing Address - Phone:949-733-8229
Mailing Address - Fax:949-733-8229
Practice Address - Street 1:2900 BRISTOL ST STE G201
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7914
Practice Address - Country:US
Practice Address - Phone:949-733-8229
Practice Address - Fax:949-733-8229
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 85681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical